{template 'default','header'}
<table width="985"  border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td valign="top"><img src="images/tm.gif" width="2" height="2"></td>
  </tr>
</table>
{template 'default','tag_banner'}

<table width="985"  border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td valign="top"><img src="images/tm.gif" width="2" height="2"></td>
  </tr>
</table>

<table width="985"  border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td width="208" valign="top">
        {template 'default','tag_right'}
        
    </td>
    <td width="771" valign="top">
        <form action="{URL}" method="post" onsubmit="return r_submit(this);">
            <table width="100%" border="1">
                <tr><td>email</td><td><input type="text" name="email"/><font color="red">*</font></td></tr>
                <tr><td>密码</td><td><input type="password" name="password" /><font color="red">*</font></td></tr>
                <tr><td>确认密码</td><td><input type="password" name="repassword" /><font color="red">*</font></td></tr>
                <tr><td>真实姓名</td><td><input type="text" name="truename" /><font color="red">*</font></td></tr>
                <tr><td>年级/班级</td><td>{form::type_level_select('types','types','major')}<font color="red">*</font></td></tr>
                <tr><td>联系方式</td><td><input type="text" name="tel" /></td></tr>
                <tr><td>所在单位</td><td><input type="text" name="department" /></td></tr>
                <tr><td colspan="2"><input type="submit" value="确认申请" /></td></tr>
                
            </table>
            
        </form>
    </td>
  </tr>
</table>

{template 'default','footer'}